[Code of Federal Regulations]
[Title 26, Volume 15]
[Revised as of April 1, 2001]
From the U.S. Government Printing Office via GPO Access
[CITE: 26CFR48.4041-15]

[Page 74-75]
 
                       TITLE 26--INTERNAL REVENUE
 
                  CHAPTER I--INTERNAL REVENUE SERVICE,
                       DEPARTMENT OF THE TREASURY
                               (Continued)
 
PART 48--MANUFACTURERS AND RETAILERS EXCISE TAXES--Table of Contents
 
                        Subpart F--Special Fuels
 
Sec. 48.4041-15  Sales to States or political subdivisions thereof.

    (a) Application of exemption. The taxes imposed by section 4041 do 
not apply in the case of a sale of any liquid by any person for the 
exclusive use of any State or any political subdivision

[[Page 75]]

thereof, the District of Columbia, or in the case of the use of any 
liquid by any State or any political subdivision thereof, or the 
District of Columbia, as a fuel in a a motor vehicle, motorboat, or 
aircraft.
    (b) Evidence required to establish exemption. Any vendor claiming 
exemption under this section shall be prepared to produce evidence that 
will establish the right to exemption from the tax imposed by section 
4041. Generally, orders or contracts of a State or a political 
subdivision thereof, or the District of Columbia, when signed by an 
authorized officer thereof will be accepted in support of the exemption. 
However, in the absence of such orders or contracts, a certificate 
signed by such an authorized officer that the liquid sold was purchased 
for the exclusive use of a State or political subdivision thereof, or 
the District of Columbia, will be acceptable. The certificate shall be 
in substantially the following form:

                          Exemption Certificate

    (For use by States and local governments. (section 4041(g)(2) of the 
Internal Revenue Code).)

Date __________, 19____.

    I hereby certify that I am ______________ of ______________ (State 
or local government) that I am authorized to execute this certificate; 
and that

                 (Check applicable type of certificate)

______the liquid or liquids specified in the accompanying order, or on 
the reverse side hereof, (or)

______all orders placed by the purchaser for the period commencing 
__________ (Date) and ending __________ (Date) (period not to exceed 12 
calendar quarters) are, or will be, purchased from __________ (Name of 
vendor) for the exclusive use of __________ (Governmental unit) of 
____________________ (State or local government).
    I understand that the exemption from tax in the case of sales of 
liquids under this exemption certificate is limited to the sale of 
articles purchased for the exclusive use of a State, etc. I understand 
that the fraudulent use of this certificate for the purpose of securing 
this exemption will subject me and all parties making such fraudulent 
use of this certificate to a fine of not more than $10,000, or to 
imprisonment for not more than 5 years, or both, together with costs of 
prosecution.

Signature ____________________

Address ____________________


[T.D. 7536, 43 FR 13516, Mar. 31, 1978. Redesignated by T.D. 8066, 51 FR 
14, Jan. 2, 1986]